Objective To explore the effect of estradiol benzoate on the expressions of heat shock protein (HSP)70, 90 in endometrial glandular epithelial cell. Methods Normal endometrial glandular epithelial cells were isolated, and cultured by enzymolysis method and identified by electron microscopy and immunohistochemical analysis. The normal endometrial glandular epithelial cells were treated with culture medium only, estradiol benzoate (10 -9 , 10 -8 , 10 -7 or 10 -6 mol/L), estradiol benzoate(10 -9 , 10 -8 , 10 -7 or 10 -6 mol/L) and antiestrogen ICI 182780(fulvestrant,faslodex, 1?mol/L)and ICI 182780 only for 6, 12, 18, 24 hours respectively. The dose-and time-related effect of estradiol benzoate and ICI 182780 on the cell growth was measured by mononuclear cell direct cytotoxicity assay (methyl thiazolyl tetrazolium assay), and that on the expression of HSP70 and HSP90 in normal endometrial glandular epithelial cell in vitro was measured by immunohistochemical analysis and computerized image analysis system. Results Estradiol benzoate stimulated cell growth in a time-and dose-dependent manner and the effect was attenuated by the antiestrogen ICI 182780. The average cell growth rates of 10 -9 , 10 -8 , 10 -7 , 10 -6 mol/L estradiol benzoate for 24 hours were(170?9)%,(207?11)%,(231?12)%,(257?10)%, which were significantly higher than those of 6 hours (117?13)%, (129?10)%, (146?10)%, (176?6)%, P

Aiming to improve the quality of teaching international students and enhance the international cooperation of medical teaching,this article discusses the teaching to international students from the aspects such as enhancing the recognition,breaking through language communication obstacles,careful preparation and teaching,and strict regular management by combining practice and research obtained from recent years of international student teaching.

ObjectiveTo explore the effect of JNK-c-Jun signal pathwayon connexin 43 (Cx43) expression and its role in renal tubular epithelial-myofibroblast transition (TEMT) induced by TGF-β1.Methods Normal rat kidney tubular epithelial cells(NRK-52E) were cultured in Dulbecco's modified eagle medium(DMEM) with 10％ fetal bovine serum,then were randomly divided into 3 groups: control group,TGF-β1 group (treated with TGF-β1 10 μg/L),and TGF-β1+SP600125 (selective JNK inhibitor,50 μmol/L) group. The protein expressions of JNK,c-Jun,α-SMA,Cx43 and E-cadherin were assayed by immunocytochemistry and Western blotting.The Cx43mRNA was assayed by RT-PCR.Gap junction intercellular communication(CJIC) was measured by fluorescence recovery after photobleaching assay(FRAP).Results TGF-β1increased the expressions of JNK,c-Jun and α-SMA(P＜0.05),reduced the expressions of Cx43 and E-cadherin (P＜0.05),and inhibited GJIC of NRK-52E(P ＜0.05).SP600125 could alleviate the above expressions changes and enhanced GJIC induced by TGF-β1.Conclusion JNK-c-Jun signal pathway induces TEMT ofNRK-52E treated with TGF-β1 viadown-regulation of connexin 43expression and inhibition of GJIC.

Objective To investigate the incidence,etiology,diagnosis,treatment and outcome of uterus rupture.Methods From January 1999 to May 2013,clinical data of 67 cases with uterine rupture in Woman's Hospital,School of Medicine,Zhejiang University were studied retrospectively.Results A total of 67 cases of uterine rupture with 21 +2--39 +2 gestational weeks out of 128 599 deliveries were recorded giving an incidence of uterine rupture was 0.052 1 ％ (67/128 599).Cesarean scar rupture were found in 59 cases (88％,59/67) and noncesarean scar rupture were found in 8 cases (12％,8/67).The causes of uterine rupture include 60 cases of scar uterus (59 cesarean scar cases and 1 myomyectomy scar case),2 cases of assisted delivery operation trauma,2 cases of malformed uterus,3 cases of unknown causes (all with artificial abortion history).Non obstructive dystocia and improper oxytocin use were found to be related with uterine rupture.Fifty-two cases of cesarean scar spontaneous incomplete rupture were found and repaired during repeated cesarean delivery without maternal and fetal complications.The remaining 15 cases need emergency rescue operation for fetal distress or dead fetus,severe acute abdomen,prepartum or postpartum vaginal bleeding even maternal hypovolemia; 6/15 uterine rupture cases were diagnosed with the history,clinical symptoms and signs,3/15 cases with ultrasonic found dead fetus in the peritoneal cavity before exploratory laparotomy and 6 cases were diagnosed just during laparotomy.Hysterectomy was done in 10/15 cases and uterine repair in 5/15 cases; there was no maternal death and 12 perinatal fetal death (5 cases of mid-late pregnancy termination for deformed fetus) of the 15 uterine rupture cases.One case with hysterectomy was complicated with stress pancreatitis and dysfunction of liver and kidney and discharged 20 days after operation,the remaining 14 cases were discharged 5-7 days postpartum.One case with repaired malformed uterus got pregnancy 4 years later and delivered a 2 000 g healthy baby by cesarean section at gestational age of 33 +4 weeks.Conclusion Uterine scar caused by caesarean section or other operations became the leading cause of uterine rupture,assisted delivery operations,history of intrauterine manipulation and uterine malformations were the predisposing risk factors of uterine rupture.

Objective To observe clinical effect of treating bedsore with myijinhuang powder. Methods 35 patients with bedsore were randomly divided into a control group and a treatment group. The treatment group was treated with ruyijinhuang powder, and the control group was treated with routine western medicine. The clinical effect was observed in both groups. Results The clinical total effective rate in the treatment group was significantly higher than that of the control group (P<0.05) . Conclusion The treatment of bedsore with ruyihuangjin powder has good effect.

Objective To explore the expression and significance of chemokine CXC reeeptor (CXCR)3 and CXCR4 and their ligands(CXCL)at the early pregnancy decidua and villi.Methods Decidual mononuclear cells were isolated from the normal decidua of 5-8 weeks pregnant women by lymphocyte separation medium in vitro.CD56+natural killer(NK)cells were purified by dynabeads cell sorter kiL Purity and phenotype of CD56+decidua NK cells were analyzed by fluorescence-activated eell sorter (FACS).Gene expression of CXCR3 and CXCR4 in decidua NK cells and CXCL9,CXCL10 and CXCL12 in early pregnancy decidua and villi was assessed bv RT.PCIZ Protein expression of CXCL9,CXCL10 in normal endometrium and early pregnancy decidua was characterized and quantified by streptavidin-biotin pemxidase chain reaction(SP)immunohistochemistry and computered image analysis system.Correlations between the gray degree of CXCL9 and CXCL10 and the number of CD56+NK cells in upper tissue were analyzed by Spearman's correlation ceefficient rank tesL Results The phenotype of 98.7%decidua NK cells was CD56bright.The genes of CXCR3 and CXCR4 were expressed in decidua NK cells and that of CXCL9 and CXCL1O were expressed in early pregnancy decidua and CXCLI2 in early pregnancy villi.CXCL9 and CXCL10 were expressed in the cytoplasm of surface epithelia,glandular epithelia and stromal cells of early pregnancy deeidua and were not expressed in villi by immunohistochemistry.The gray degree of CXCL9 and CXCL10 in the secretory phase endometrium(56±43,59±47)was stronger than that in the proliferative phase(16±18,8±14,P<0.05)and reached the highest(143±35,158±29,P<0.05)in the early pregnancy decidua.The number of cD+56 NK cell in the secretory phase endometrium(60±20)was more than that in the proliferative phase endometrium(23±4,P<0.05)and was the most in the early pregnancy decidua(114±15,P<0.05).The gray degree of CXCL9 in upper tissue had a positive correlation with the number of CD+56 cells(r=0.88,P<0.05)and that of CXCL10 had a similar pattern to CXCL9(r=0.86,P<0.05).Condusion The interactions between CXCL9,CXCL10 and CXCL12 expressed in decidua and villi and CXCR3,CXCR4 expressed in CD+56 decidua NK cells may influence the CD+56 NK cell recruitment at the maternal-fetal interface.

0.05).The major toxicity and side effects were bone marrow inhibition,gastrointestinal reaction and mucosal reaction.The difference of hematologic toxicity and gastrointestinal between the two groups was statistically significant(P0.05).The GEM group could be well tolerated for the concurrent chemoradiotherap of patients with stage Ⅲ～Ⅳa nasopharyngeal carcinoma(NPC).

Objective To investigate the incidence of and risk factors for benign prostatic hyperplasia (BPH) in transplant recipients.Methods 197 males aged 50 years and older who received kidney transplants were recruited if they were clinically stable.They were divided into three age groups:50 to 59 years (87 cases),60 to 69 years (64 cases) and ≥ 70 years (46 cases).Two hundred and forty people who had not undergone kidney transplant were randomly selected from the community as controls.A cross-sectional study was performed to study the BPH incidence in kidney transplant recipients according to standard diagnostic criteria.At the same time,the expression levels of keratinocyte growth factor,transforming growth factor-β and serum testosterone and the CD4/CD8 ratio in T lymphocytes were determined.Results There was no significant difference in age,PSA and the postmicturition residual volume between the study group and the control group.The total BPH incidence in kidney transplant recipients was 16.2％ (32/197).The symptomatic BPH incidence was 6.9％ (6/87) in the 50-to 59-year-old study group and 20.2％ (19/94) in the control group,representing a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.010).The symptomatic BPH incidence was 18.8％ (12/64) in the 60-to 69-year-old study group and 41.9％ (34/81) in the control group,indicating a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.004).The symptomatic BPH incidence was 30.4％ (14/46) in the ≥ 70-year-old study group and 52.3％ (34/65) in the control group,indicating a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.032).Compared to the control group,the peripheral blood serum testosterone level (9.4 ± 4.7,18.2 ± 5.6,P =0.040) and the CD4/CD8 ratio (1.1±0.3,1.8±0.3,P=0.014) of kidney transplant recipients was lower.The transforming growth factor-β expression level (5015± 1087,1829±963,P＜0.001) was higher in kidney transplant recipients than in the control group.The kasatinocyte growth factor expression levels (35.8±20.7,21.0± 18.3,P =0.064) was not statistically different than in the control group.Conclusions Kidney transplant recipients who had long-term administration of calcineurin inhibitor might have a low benign prostatic hyperplasia incidence,which might be related to transforming growth factor-β and keratinocyte growth factor expression,testosterone levels and the lymphocyte infiltration.Further high-quality prospective studies are still needed to confirm the conclusions.

OBJECTIVE: To discuss the safe approach to exposure of the recurrent laryngeal nerve (RLN) in thyroid second operation. METHOD: The data of 153 patients with thyroid second operation were analyzed retrospectively to compare the effectiveness of superior and inferior approach in the exposure of RLN. RESULT: A total of 177 RLNs were exposed in 153 cases. Among those 39 RLNs were exposed by superior approach, 34 by inferior approach after failure of superior approach, and 104 by inferior approach. CONCLUSION In thyroid second operation, inferior approach is a safe and efficient method to expose RLN. Trachea and esophagus are the most important anatomical landmarks to look for the left RLN. Innominate artery and common carotid artery are the most important anatomical landmarks to look for right RLN.
Carotid Artery, Common ; Esophagus ; Humans ; Recurrent Laryngeal Nerve ; surgery ; Reoperation ; Retrospective Studies ; Thyroid Gland ; surgery ; Trachea

Objective To observe the protein expressions of PI3Kp110, pAkt, pGSK3β of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (Akt) signaling pathway in the whole blood of patients with Kashin-Beck disease and analyze the status of PI3K/Akt signaling pathway. Methods Patients with Kashin-Beck disease ( KBD group ) were from six counties ( Xunyi , Linyou , Yongshou , Qianyang , Changwu and Long County) of Shannxi Province in Kashin-Beck disease areas , and the healthy controls (control group) were matched by age and sex. Venous blood was collected from patients and healthy controls. Trizol method was applied to extract the whole blood protein; protein expression levels of PI3K/Akt signaling pathway in whole blood were detected by Western blotting; the gray values were observed and recorded by the sodium dodecyl sulfate polyacrylamide gel electrophoresis(SDS-PAGE) and GDS-8000 gel imaging analysis system. Differences between the two groups were assessed by Student’s t-test. Results Compared age and sex between KBD group and control group, differences were not statistically significant(t=0.701, P>0.05;χ2=0.400, P>0.05). The protein expression levels of PI3Kp110, pAkt and p-GSK3β in KBD group were higher than that in control group(156.1 ± 92.1 vs. 79.5 ± 21.5, 113.7 ± 15.2 vs. 43.3 ± 10.7 and 105.9 ± 17.5 vs. 37.3 ± 12.0, respectively) and the differences were statistically significant (t=2.563, 6.567, 7.916; all P < 0.05 or < 0.01). Conclusion The PI3Kp110, pAkt and p-GSK3β expressions of signaling pathway proteins in the whole blood of patiens with Kashin-Beck disease are up-regulated significantly and the status of PI3K/Akt signaling pathway is activated.